Radionuclide diagnostics of pulmonary embolism: imaging of perfusion and lung ventilation, evaluation of contractility of the right ventricle in pulmonary embolism

The first part of the review presents the basic facts about epidemiology, etiology, pathogenesis and outcomes of pulmonary embolism (PE). Mechanisms of development of pulmonary hypertension, dysfunction and failure of right ventricle peculiar for PE are described. Information about low specificity of clinical signs of PE and thus the necessity of instrumental methods of diagnostics are represented. The second part of the review defines radionuclide diagnostics of PE in comparison with other modern radiological modalities. According to some authors, diagnostic accuracy criteria of VQ scintigraphy in case of great vessels pulmonary embolism are comparable to the same criteria when using CT and MR angiography. However in case of distal vessels pulmonary embolism the diagnostic accuracy of radionuclide scintigraphy significantly increases. The third part of the review is devoted to the modern approaches to the assessment of functional condition of right ventricle in patients with PE. In the conclusion, there are arguments based on published experimental and clinical works, in favor of the fact that radionuclide methods are equal or even exceed other diagnostic modality in accuracy of estimating basic parameters of right ventricle contractility and thus may be used for evaluation of severity and prognosis of right ventricle failure in patients with PE.